NPIMap

Organization Active NPI

Programa Sida de San Juan-Lab

  • Clinical Medical Laboratory
  • San Juan, PR
National Provider Identifier
1346451895
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CLIA 40D0919476 Issued in PR
Legal business name
PROGRAMA SIDA DE SAN JUAN-LAB
Practice address
1306 Ave Fernandez Juncos
San Juan, PR 00909-2521
Phone
(787) 723-2424
NPI assigned
May 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Luis V Clas, MD
Title
Executive Director/Ceo
Phone
(787) 480-3838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLIA 40D0919476 PR Primary

Addresses

Primary practice location

1306 Ave Fernandez Juncos
San Juan, PR 00909-2521

Mailing address

1306 Ave Fernandez Juncos
San Juan, PR 00909-2521
Phone (787) 723-2424

Other identifiers 1

IdentifierTypeStateIssuer
40D0919476OtherPRCLIA

Other names 1

  • Programa Sida de San Juan-Lab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051109000215 PR Part A Provider - Hospital 5597711945 15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Juan, PR

Hospital certification: CCN 400015

Legal name
MUNICIPALITY OF SAN JUAN PR
Doing business as
SAN JUAN MUNICIPALITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 1, 2023
Beds
450
Ownership / control type
Local
Organization structure
GovernmentNon-profit
Enrollment address
Bo Monacillos Centro Medico Rio Piedras
San Juan, PR 926
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

Care Compare: Hospital

Medicare Care Compare
Listed as
San Juan Municipality HospitalCCN 400015
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
CDT Dr a J Garcia63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Luis V Clas Individual Corporate Officer Jan 11, 2021
Corporate Director Jan 11, 2021
W-2 Managing Employee Jan 11, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Luis V Clas, M.D.
    • Emergency Medicine Physician
    • San Juan, PR
    • NPI 1497733349

    Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 20

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1346451895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 AVE FERNANDEZ JUNCOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092521",
            "telephone_number": "787-723-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 AVE FERNANDEZ JUNCOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092521",
            "telephone_number": "787-723-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRAMA SIDA DE SAN JUAN-LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "CLAS",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CEO",
        "authorized_official_telephone_number": "787-480-3838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "CLIA 40D0919476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "40D0919476",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Programa Sida de San Juan-Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.